Depression is, unfortunately, very common in Parkinson’s disease and patients with PD need monitoring for depressive symptoms. Randomized controlled trials of treatment are, however, few and far between.

It’s generally held that treatment of the motor aspects of PD should be optimized first. Some patients’ depression does improve with dopaminergic therapy. Psychosocial and behavioural support is also important. SSRIs or tricyclics have often been used. Electroconvulsive therapy may be used in recalcitrant cases.

There aren’t rigorous studies to guide antidepressant drug selection in PD but it’s worth remembering that tricyclics may have significant anticholinergic properties that may cause unwanted systemic and cognitive side effects. SSRIs are more commonly used nowadays and are generally well-tolerated in this population.

Reference

Veazey et al. J Neuropsychiatry Clin Neurosci 2005;17:310-23

ENTER KEYWORD(S)

To search a phrase, use quotation marks (e.g. "back pain")